Parkland report says privatized surgeries only making things worse

By ANNA SMITH Local Journalism Initiative on March 27, 2025.

asmith@medicinehatnews.com

A report released by the Parkland Institute seeks to highlight how privatization of surgeries in Alberta is undermining public hospitals and prolonging wait times for critical surgeries.

In a webinar following the the release of Operation Profit: Private Surgical Contracts Deliver Higher Costs and Longer Waits, author and health policy researcher Andrew Longhurst spoke on his findings and stated that with the backdrop of ongoing allegations regarding the province’s health-care procurement practices, “The report highlights a surge in the average cost of outsourced procedures, a steep increase not justified by inflation or service complexity.”

“At the same time, a troubling trend emerges as Alberta’s per-capita hospital spending declines, while funding for for-profit surgical facilities grows significantly,” said Longhurst. “And after five years, the Alberta surgical initiative is still failing to deliver increased provincial surgical capacity and reducing wait times for most priority procedures, despite claims from government otherwise.”

He says the report found that since the Alberta Surgical Initiative began in 2019, there has been a 179 per cent increase in total public payments to chartered surgical facilities.

In fiscal year 2023-2024 the amount paid to these for-profit facilities was $55.8 million in facility fees, not including physician billings to the Alberta Health Care Insurance Plan.

Between fiscal years 2022-2023 and 2023-2024, the average cost of an outsourced procedure increased by 52 per cent, said Longhurst.

“We also see that public spending on for-profit facilities has outpaced public hospital spending by quite a lot since the Alberta surgical initiative for the ASI was launched in December 2019,” said Longhurst.

He continued on to say that unlike other provinces such as Quebec, British Columbia and Ontario, which have increased real per-capita hospital spending, Alberta’s decreased 11 per cent between 2013 and 2022.

“If Alberta hospitals seem like they are trying to do more with less, it is certainly not your imagination,” said Longhurst. “Provincial hospital expenditures as a share of GDP in Alberta declined from 2.2 per cent in 2013 to 2 per cent in 2022, which is the most recent year available, making it the lowest in the country.”

With declining investment in hospitals as health-care workers have continued to share warnings of the reality of their workplaces, Longhurst says, his report also notes a rising number of scheduled procedures in private facilities.

“The most troubling finding, I think, is that public operating room activity was actually lower in the most recent year than even pre-pandemic,” said Longhurst, saying this is consistent with his findings from a previous report that suggested policy was encouraging workers to move into the for-profit sector.

“Keep in mind (the private surgical sector) only performs the lowest complexity surgeries, does not provide emergency care and does not provide follow-up care,” said Longhurst. “And this is having real consequences on how Albertans are able to access life-saving health care in the province, and specifically surgical care.”

Median wait times have increased under the Alberta Surgical Initiative, said Longhurst, “exactly the opposite of what the government has claimed the initiative would do.”

With a finite number of qualified surgeons, nurses, allied health professionals and support staff, this move toward the private sector has impacted the ability to ensure there are professionals at the ready in the event of an emergency, said Longhurst.

The report emphasized that Alberta should use evidence-based strategies, including properly funding public hospitals, staffing existing operating rooms during idle hours and adopting centralized waitlists provincially.

“In most cases, Alberta doesn’t lack the physical space to perform surgeries,” said Longhurst. “What it lacks is the nursing and medical workforce needed to increase surgical activity.”

The full report is available at parklandinstitute.ca/operation_profit.

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